Prevalence rate of Metabolic Syndrome in a group of light and heavy smokers

The inverse relationship between Life's Essential 8 and risk of metabolic syndrome: evidence from NHANES 2005-2018

Background

Metabolic syndrome (MetS) has a close association with cardiovascular diseases. Few studies have investigated the association of Life's Essential 8 (LE8), the updated measurement of cardiovascular health (CVH), with MetS.

Methods

The National Health and Nutrition Examination Survey (2005-2018) data was extracted. The LE8 comprised 4 health behaviors (diet, physical activity, nicotine exposure, and sleep health) and 4 health factors [body mass index (BMI), blood lipids, blood glucose, and blood pressure (BP)]. The total LE8 score is the average of 8 metric scores (0-100), categorized into low (0-49), moderate (50-79), and high CVH (80-100) levels. Multivariable logistic regression models, restricted cubic spline models and stratified analyses were performed to examine the relationship between LE8 and MetS.

Results

In this study, a total of 21,543 participants represented 146.6 million non-institutionalized U.S. adults. Following adjustment for various potential covariates, participants who attained a moderate [adjusted odds ratio (AOR) = 0.234, 95% CI: 0.209, 0.262] or a high CVH level (AOR = 0.026, 95% CI: 0.021, 0.032) exhibited an inverse correlation with MetS risks when comparing those with a low CVH level. An inverse linear dose-response relationship between LE8 scores and MetS risks was also identified (P for nonlinearity > 0.05).

Conclusions

LE8 was inversely associated with the risk of MetS. Adhering to LE8 guidelines to sustain a higher CVH level may be beneficial for preventing MetS.

Prevalence and Incidence of Metabolic Syndrome and Its Components Among Waterpipe Users

Objectives

To determine the associations between waterpipe use, duration, and intensity of use with prevalence and incidence of metabolic syndrome and its components (increased waist circumference, triglycerides, fasting glucose, blood pressure and decreased high-density lipoprotein cholesterol).

Methods

We conducted cross-sectional and prospective analyses using data from the Pars Cohort Study in southern Iran, encompassing 9,264 participants at the baseline, and 5,002 randomly selected in a repeated follow-up. We used multivariate logistic regression models adjusted for age, sex, education, wealth score, physical activity and cigarette pack-years to report odds ratios (OR) and 95% confidence intervals (CI).

Results

Among 9,264 participants, 3,119 (33.7%) had metabolic syndrome, and 3,482 (37.6%) had ever smoked waterpipe, with both more common in women than in men. In adjusted models, former waterpipe use was significantly associated with prevalence (OR = 1.43, 95% CI: 1.23-1.68) and incidence (OR = 1.57, 95% CI: 1.19-2.06) of the metabolic syndrome while current waterpipe use was not. Past use was associated with increased risk in all components of metabolic syndrome; current use was associated with increases in all except high blood glucose and hypertension. Past waterpipe users had higher waterpipe use intensity (before quitting) in comparison with current users (2.3 vs. 2.0 waterpipes per day, p < 0.01) and had started waterpipe smoking at a younger age (27.2 vs. 30.1 years, p < 0.01).

Conclusion

Waterpipe use was associated with metabolic syndrome and its components, especially among former users potentially due to higher intensity and earlier initiation of use.

An interpretable knee replacement risk assessment system for osteoarthritis patients

Objective

Knee osteoarthritis (OA) is a complex disease with heterogeneous representations. Although it is modifiable to prevention and early treatment, there still lacks a reliable and accurate prognostic tool. Hence, we aim to develop a quantitative and self-administrable knee replacement (KR) risk stratification system for knee osteoarthritis (KOA) patients with clinical features.

Method

A total of 14 baseline features were extracted from 9592 cases in the Osteoarthritis Initiative (OAI) cohort. A survival model was constructed using the Random Survival Forests algorithm. The prediction performance was evaluated with the concordance index (C-index) and average receiver operating characteristic curve (AUC). A three-class KR risk stratification system was built to differentiate three distinct KR-free survival groups. Thereafter, Shapley Additive Explanations (SHAP) was introduced for model explanation.

Results

KR incidence was accurately predicted by the model with a C-index of 0.770 (±0.0215) and an average AUC of 0.807 (±0.0181) with 14 clinical features. Three distinct survival groups were observed from the ten-point KR risk stratification system with a four-year KR rate of 0.79%, 5.78%, and 16.2% from the low, medium, and high-risk groups respectively. KR is mainly caused by pain medication use, age, surgery history, diabetes, and a high body mass index, as revealed by SHAP.

Conclusion

A self-administrable and interpretable KR survival model was developed, underscoring a KR risk scoring system to stratify KOA patients. It will encourage regular self-assessments within the community and facilitate personalised healthcare for both primary and secondary prevention of KOA.

Interactive associations of smoking and physical activity with metabolic syndrome in adult men in Korea

Introduction

This study aimed to investigate the association of smoking and physical activity (PA) with metabolic syndrome (MetS) in adult men in Korea.

Methods

This study analyzed data of 7,229 adult men aged 19-64 years obtained from the 2014-2021 Korea National Health and Nutrition Examination Survey (KNHANES). Information on smoking habits was obtained using KNHANES data, while that on total PA (TPA), leisure-time PA (LTPA), and occupational PA (OPA) was collected using the Global Physical Activity Questionnaire. Smoking status was classified into non-smokers and smokers, and PA was categorized into three groups (total, leisure time, and occupational) according to the time spent engaging in moderate or high-intensity PA areas. The diagnosis of MetS was based on the Adult Treatment Program III of the National Cholesterol Education Program and Koreans' waist circumference criteria.

Results

Logistic regression revealed that the risk of MetS was significantly lower in non-smokers than in smokers, even after adjusting for all covariates. The risk of MetS was significantly lower in individuals who engaged in at least 150 min of moderate- and high-intensity TPA or LTPA per week than in those who did not engage in PA. Furthermore, smokers who engaged in at least 150 min of moderate- to high-intensity TPA and LTPA per week had a significantly lower risk of MetS than those who did not engage in PA. Meanwhile, OPA was not associated with MetS.

Conclusion

The findings suggest that engaging in moderate- to high-intensity TPA or LTPA for at least 150 min per week attenuates the risk of MetS caused by smoking.

Assessment of Lifestyle, Eating Habits and the Effect of Nutritional Education among Undergraduate Students in Southern Italy

BACKGROUND

The years spent at university represent a critical period that can influence both the quality of lifestyle and the eating habits of subsequent adulthood, and also, in the long term, the health of the individual. The aim of this study was to investigate the lifestyle of university students living away from home.

METHODS

Each subject recruited for the study was given a questionnaire to obtain general information, eating habits and physical activity levels before (T0) and after six month of training seminars (T1). Blood pressure, body composition and questionnaire responses were investigated.

RESULTS

The main findings of this study are a significant decrement in blood pressure; an increment in physical activity practice; an increased number of subjects who pay attention to the calorific value of food and also an improvement in BIA parameters.

CONCLUSIONS

In conclusion, this study demonstrated the challenges that university students face in leading a healthy lifestyle and caring for their nutritional needs, particularly when they are away from their families. No intervention specifically targets young adults, even though much emphasis is placed on the promotion of a healthy lifestyle based on a varied and balanced diet and sufficient exercise. Our study showed that it is possible to improve lifestyle through educational events aimed at making students aware of the health risks deriving from unhealthy lifestyles.

The Effects of Smoking on the Diagnostic Characteristics of Metabolic Syndrome: A Review

Metabolic syndrome is a growing epidemic that increases the risk for cardiovascular disease, diabetes, stroke, and mortality. It is diagnosed by the presence of three or more of the following risk factors: 1) obesity, with an emphasis on central adiposity, 2) high blood pressure, 3) hyperglycemia, 4) dyslipidemia, with regard to reduced high-density lipoprotein concentrations, and 5) dyslipidemia, with regard to elevated triglycerides. Smoking is one lifestyle factor that can increase the risk for metabolic syndrome as it has been shown to exert negative effects on abdominal obesity, blood pressure, blood glucose concentrations, and blood lipid profiles. Smoking may also negatively affect other factors that influence glucose and lipid metabolism including lipoprotein lipase, adiponectin, peroxisome proliferator-activated receptors, and tumor necrosis factor-alpha. Some of these smoking-related outcomes may be reversed with smoking cessation, thus reducing the risk for metabolic disease; however, metabolic syndrome risk may initially increase post cessation, possibly due to weight gain. Therefore, these findings warrant the need for more research on the development and efficacy of smoking prevention and cessation programs.

How Healthy Are Health-Related Behaviors in University Students: The HOLISTic Study

The aim of this cross-sectional study was to assess the health-related behaviors among university students, with emphasis on health sciences students from Croatia, Italy, Lebanon, Poland, Romania, Spain and Turkey. We included 6222 students in Medicine, Dentistry, Nursing, Pharmacy, Nutrition and Dietetics, Sports Sciences, Veterinary, and Economics enrolled between April 2018 and March 2020. We assessed dietary patterns, sleeping habits, physical activity and perceived stress among students by means of validated questionnaires. The median age ranged between 19 and 24 years, smoking prevalence between 12.0% and 35.4%, and body mass index (BMI) ranged between 21.1 and 23.2 kg/m2. Breakfast was less often and more often consumed daily in Turkey (36.7%), and Italy (75.7%), respectively. The highest Mediterranean diet score was recorded in Spain and Italy, and the lowest in Turkey, followed by students from Croatia, Lebanon, Poland and Romania. Sleep duration, physical activity and stress perception also differed between countries. Multivariable regression analysis revealed a small, but positive association between BMI and several characteristics, including age, female gender, smoking, physical activity, mobile phone use, and perceived stress. A negative association was found between BMI and sleep duration on non-working days. Self-rated health perception was positively associated with female gender, breakfast, physical activity, and time spent studying, and negatively with BMI, smoking and stress. Our results demonstrated diverse habits in students from different countries, some of which were less healthy than anticipated, given their educational background. Greater emphasis needs to be placed on improving the lifestyle of these adolescents and young adults, who will be tomorrow's healthcare workers.

Prevalence of metabolic syndrome in patients with chronic obstructive pulmonary disease: An observational study in South Indians

BACKGROUND AND AIMS

Metabolic syndrome (MetS) has a significant association with airflow obstruction and physical inactivity, which are the relevant extra-pulmonary markers of chronic obstructive respiratory disease (COPD). This study aimed to estimate the prevalence of MetS and its correlation with comorbidities and health related quality of life (HRQoL) in South Indian patients with COPD.

METHODS

A cross-sectional study was conducted among the 76 COPD patients. Pulmonary function test (PFT) and parameters for MetS such as waist circumference, blood pressure, fasting blood glucose, triglycerides (TGs) and high density lipoprotein cholesterol (HDL-C) levels of COPD patients were measured. HRQoL was calculated using Saint George Respiratory Questionnaire (SGRQ).

RESULTS

54% of COPD patients were presented with MetS especially in stage II and III. TGs and HDL-C were significantly associated with the severity of COPD (p < 0.05), while waist circumference, TGs and HDL-C were significantly (p < 0.05) correlated with PFT. Symptom, activity, impact and total scores of SGRQ was increased statistically (p < 0.05) in COPD patients with MetS than without MetS.

CONCLUSION

According to our findings, screening the grade II and III COPD patients for the presence of MetS is a reasonable option. The results of this study should be confirmed with a larger sample of population.

Cigarette smoking and knee osteoarthritis in the elderly: Data from the Korean National Health and Nutritional Examination Survey

BACKGROUND

The relationship between smoking and osteoarthritis (OA) has not been investigated in a large-scale study. The aim of this study was to examine the relationship between smoking and knee OA in the elderly.

METHODS

This study included 5117 subjects aged >60 years who responded to questionnaires on their history of smoking and knee OA diagnosed by a physician taken from the Korean National Health and Nutritional Examination Survey (KNHANES-VI) 2013-2015. We classified all 5117 subjects into 2 groups (the OA group and non-OA group) and compared the demographics and characteristics between the 2 groups. A multivariate logistic regression analysis was conducted to investigate the possible association between knee OA and smoking.

RESULTS

The prevalence of current smoking in the OA group (5.1%) was significantly lower than in the non-OA group (14.6%; p < 0.001). Furthermore, the proportion of moderate smokers who smoked >10 cigarettes per day or heavy smokers who smoked >20 cigarettes per day was significantly higher in the non-OA group. In the multivariate analysis, current smoking history was a preventative factor for the prevalence of OA in a multivariate model that included age, sex, body mass index, waist circumference (OR: 0.752, 95% CI: 0.571-0.989, p = 0.042).

CONCLUSIONS

This large-scale national study highlights an inverse association between smoking and the prevalence of knee OA in the general Korean elder adult population, primarily in males. Further investigation of this relationship between smoking and knee OA is needed to determine smoking's specific mechanism of protection against knee OA.

Light smoking is associated with metabolic syndrome risk factors in Chilean young adults

AIMS

Metabolic syndrome (MetS) is a cluster of risk factors for cardiometabolic diseases. While cigarette smoking is associated with MetS in adults, young adulthood is an under-studied, susceptible period for developing long-term morbidity from MetS. We examined associations between cigarette smoking and MetS risk factors.

METHODS

We studied 430 participants in Santiago, Chile who have been followed in a longitudinal cohort since infancy and assessed in adolescence for MetS. Participants were evaluated at 22 years from May 2015 to July 2017. Adiposity, blood pressure, and blood samples were measured. MetS was defined using International Diabetes Federation criteria. A continuous MetS score was calculated using z-scores. Participants self-reported cigarette and alcohol consumption using standardized questionnaires. We used multivariate regressions to examine associations between smoking and MetS risk factors, adjusting for sex, MetS in adolescence, alcohol consumption, and socioeconomic status.

RESULTS

Thirteen percent of participants had MetS and 50% were current smokers. Among smokers, mean age of initiation was 14.9 years and consumption was 29 cigarettes weekly. Smokers had larger waist circumferences, higher BMIs, and lower high-density lipoprotein (HDL) cholesterol compared to non-smokers. Being a current smoker was significantly associated with higher waist circumference (β = 2.82; 95% CI 0.63, 5.02), lower HDL (β = - 3.62; 95% CI - 6.19, - 1.04), higher BMI (β = 1.22; 95% CI 0.16, 2.28), and higher MetS score (β = 0.13, 95% CI 0.02, 0.24).

CONCLUSIONS

Cigarette smoking at light levels (mean < 30 cigarettes weekly) was associated with MetS risk factors in a sample of Chilean young adults.

Gender differences in lifestyle and risk factors of metabolic syndrome: Do women have better health habits than men?

AIMS AND OBJECTIVES

To examine the gender-specific lifestyles of adults with metabolic syndrome in the Taiwanese community.

BACKGROUND

Many studies show different prevalence of metabolic syndrome in males and females; however, few studies have investigated gender-specific lifestyle risk factors, which are important for effectively reducing prevalence.

DESIGN

A cross-sectional study design was used.

METHODS

Between 2012 and 2015, a total of 1,066 individuals were recruited in northern Taiwan. Data were collected by questionnaires and analysed by descriptive statistics, chi-square tests and logistic regression. This study followed the STROBE guidelines.

RESULTS

The prevalence of metabolic syndrome was 40.8% in men and 36.0% in women. Women had healthier dietary habits, a higher rate of moderate-vigorous physical activity, and a lower rate of smoking and obesity than men. Men, who were overweight or obese, lacked vigorous physical activity, often consumed excess amounts of salt and fat, and seldom consumed appropriate amounts of protein tended to have metabolic syndrome. Women with an unhealthy metabolism tended to be overweight or obese and seldom consumed dairy products.

CONCLUSIONS

Men, who had normal body weight, performed vigorous physical activity, seldom consumed excess amounts of salt and fat, and often consumed appropriate amounts of protein tended not to have metabolic syndrome. Women with a healthy metabolism were of normal body weight and often consumed dairy products. There exist gender differences in health habits with metabolic syndrome.

RELEVANCE TO CLINICAL PRACTICE

Although the associated risk factors differed between men and women, controlling body weight and maintaining a healthy lifestyle may reduce the risk of metabolic syndrome.

Association of Metabolic Syndrome with the Severity of Airflow Obstruction in Patients with Chronic Obstructive Pulmonary Disease

BACKGROUND

Metabolic Syndrome (MetS) is common in Chronic Obstructive Pulmonary Disease (COPD) patients but their association is still an unsettled issue. The aim of this study was to determine the association of MetS with the severity of airflow obstruction.

METHODOLOGY

This was a cross-sectional analytic study of 157 patients with COPD. They were classified using the Global Initiative for Chronic Obstructive Lung Diseases (GOLD). MetS was assessed using two well-recognized criteria. Demographics, clinical data, lifestyle-related characteristics, fasting blood sugar (FBS) and lipid profile were obtained. Multiple logistic regression was used to determine the association of MetS with the severity of airflow obstruction.

RESULTS

40.13% and 17.20% of patients had MetS using the NCEP/ATP III-AHA/NHBLI and IDF criteria, respectively. MetS was not associated with severity of airflow obstruction. Of the MetS components, only elevated blood pressure (BP) was significantly associated with severity of airflow obstruction (GOLD II: OR=3.28, p<0.001; GOLD III: OR=4.04, p=0.2; GOLD IV: OR=6.21, p=0.04). Elevated FBS was also associated with GOLD IV (OR=16.09, p=0.02). Significant factors associated with MetS in COPD patients were body mass index, inhaled steroid, number of pack-years, and GOLD II.

CONCLUSION

MetS is not associated with severity of airflow obstruction. Only certain components of MetS showed significant associations such as elevated BP with GOLD II-IV and elevated FBS with GOLD IV.

The Impact of Innovative Smoking Reduction Education at Hospital Entrances: A Prospective Pre- and Post-Test Study Design

Background: Nurses are expected to play an important role in smoking reduction education. Although the smoking ban was enacted in Taiwan in 1997, which included the introduction of smoking-free areas around the entrances of hospitals, many smokers are still found near hospitals. Few smoking reduction programs have been initiated around hospital entrances. The aim of this study was to examine the impacts of an innovative smoking reduction education program, which was conducted by nursing students around the entrances of a teaching hospital. Methods: A prospective pre- and post-test study design was used. The smoking reduction education program consisted of posters, audio broadcasts, and dramatic performances that provided information and resources related to smoking reduction. Outcome variables included the number of smokers, number of cigarette butts on the ground, and the experiences from nursing students after conducting the program. Results: After adjusting for weather and temperature, the number of smokers decreased significantly in the afternoon and during the whole day after the implementation of the program. The number of cigarette butts significantly decreased during the implementation of the program. Conclusion: The findings reveal that alternative smoking reduction programs initiated around hospital entrances significantly reduced both the number of smokers and cigarette butts on the ground. Nursing students shared their positive experiences in conducting this study.

The association between smoking and cardiometabolic risk among male adults with disabilities in Taiwan

BACKGROUND

Individuals with disabilities have health needs similar to the general population. Smoking and metabolic syndrome have emerged as major cardiovascular risks that contribute to systemic inflammation and mortality. However, few studies have focused on the association between smoking and cardiometabolic risks in adult men with disabilities.

AIMS

This study explored the prevalence of smoking and its association with cardiometabolic risk and associated factors among male adults with disabilities.

METHODS

This study was part of a nurse-led health-promotion program designed to examine the health needs in health programs for adults with disabilities. A community-based, cross-sectional study was conducted between July 2013-December 2014, in Chiayi County, Taiwan.

RESULTS

Of the total of 964 male participants enrolled in this study, 874 (90.7%) participants had complete data sets. The prevalence of cigarette smoking and metabolic syndrome were 42%, and 33.3%, respectively. More than half (62.7%) had high blood pressure and 43.5% had central obesity. Compared with non-smokers, smokers tended to engage in less frequent regular exercise ( p<0.001), eat fewer vegetables and fruit ( p<0.05), and drink less water ( p<0.05). After adjusting for potential confounding variables, multivariable logistic regression analysis showed that smoking was an independent factor for cardiometabolic risk.

CONCLUSION

The present findings show a high prevalence of cigarette smoking, unhealthy lifestyle, and cardiometabolic risk among adult men with disabilities. Clinicians and primary healthcare providers should reduce the consequences thereof by initiating innovative health promotion programs.

Physiopathological relationship between chronic obstructive pulmonary disease and insulin resistance

PURPOSE

Chronic obstructive pulmonary disease (COPD) is characterized by persistent and progressive airflow obstruction that is associated with an abnormal chronic inflammatory response in the airways and lungs to noxious particles. COPD often leads to physical inactivity and deconditioning that added to inappropriate/excessive inflammatory responses leads to systemic consequences. Studies have shown that metabolic syndrome and manifested diabetes are more frequent in COPD than in healthy subjects; a possible explanation is that different pathophysiological aspects of COPD can lead to insulin resistance. Thus, this mini-review aims to present the main studies suggesting a pathophysiological relationship between COPD and insulin resistance.

METHODS

A review of literature was conducted using PubMed and Web of Science databases with the aim of searching for studies supporting a relationship between COPD and insulin resistance.

RESULTS

A physiopathological relationship between COPD and insulin resistance was found, supported in part due to common risk factors presented by these two conditions, such as smoking and physical inactivity. Also, systemic effects (worsening of physical inactivity and sedentary behavior, inflammation and oxidative stress, body composition abnormalities) and the corticosteroid treatment of patients with COPD may play a role.

CONCLUSION

Patients with COPD should be screened for abnormalities in insulin sensitivity in order to reduce morbidity and improve health status in this population.

Brain Structure Alterations in Respect to Tobacco Consumption and Nicotine Dependence: A Comparative Voxel-Based Morphometry Study

The main purpose of this study is to examine the lifetime tobacco consumption and the degree of nicotine dependence related gray matter (GM) and white matter (WM) volume alterations in young adult-male smokers. Fifty-three long-term male smokers and 53 well-matched male healthy non-smokers participated in the study, and the smokers were respectively categorized into light and heavy tobacco consumption subgroups by pack-years and into moderate and severe nicotine dependence subgroups using the Fagerström Test for Nicotine Dependence (FTND). Voxel-based morphometry analysis was then performed, and ANCOVA analysis combined with subsequent post hoc test were used to explore the between-group brain volume abnormalities related to the smoking amount and nicotine dependence. Light and heavy smokers displayed smaller GM and WM volumes than non-smokers, while heavy smokers were found with more significant brain atrophy than light smokers in GM areas of precuneus, inferior and middle frontal gyrus, superior temporal gyrus, cerebellum anterior lobe and insula, and in WM areas of cerebellum anterior lobe. However, the contrary trend was observed regarding alterations associated with severity of nicotine dependence. Severe nicotine dependence smokers rather demonstrated less atrophy levels compared to moderate nicotine dependence smokers, especially in GM areas of precuneus, superior and middle temporal gyrus, middle occipital gyrus, posterior cingulate and insula, and in WM areas of precuneus, posterior cingulate, cerebellum anterior lobe and midbrain. The results reveal that the nicotine dependence displays a dissimilar effect on the brain volume in comparison to the cigarette consumption. Our study could provide new evidences to understand the adverse effects of smoking on the brain structure, which is helpful for further treatment of smokers.

Metabolic syndrome and Chronic Obstructive Pulmonary Disease (COPD): The interplay among smoking, insulin resistance and vitamin D

Background

A close relationship between Metabolic Syndrome (MetS) and Chronic Obstructive Pulmonary Disease (COPD) has been described, but the exact nature of this link remains unclear. Current epidemiological data refer exclusively to the MetS prevalence among patients with COPD and data about the prevalence of COPD in MetS patients are still unavailable.

Aim of the study

To analyse and compare risk factors, clinical and metabolic characteristics, as well as the main respiratory function parameters, among patients affected by MetS, COPD or both diseases.

Patients

We recruited 59 outpatients with MetS and 76 outpatients with COPD. After medical history collection, physical examination, blood sampling for routine analysis, spirometric evaluation, they were subdivided into MetS (n = 46), MetS+COPD (n = 60), COPD (n = 29).

Results

A MetS diagnosis was assigned to 62% of COPD patients recruited in the COPD Outpatients Clinic of the Pneumology Department, while the COPD prevalence in MetS patients enrolled in the Internal Medicine Metabolic Disorders Outpatients Clinic was 22%. More than 60% of subjects enrolled in each Department were unaware that they suffered from an additional disease. MetS+COPD patients exhibited significantly higher C-peptide levels. We also found a positive relation between C-peptide and pack-years in all subjects and a negative correlation between C-peptide and vitamin D only in current smokers. Finally, a negative association emerged between smoking and vitamin D.

Conclusions

We have estimated, for the first time, the COPD prevalence in MetS and suggest a potential role of smoking in inducing insulin resistance. Moreover, a direct effect of smoking on vitamin D levels is proposed as a novel mechanism, which may account for both insulin resistance and COPD development.

Evaluation of eating habits and lifestyle in patients with obesity before and after bariatric surgery: a single Italian center experience

BACKGROUND

The study evaluated and compared the eating habits and lifestyle of patients with moderate to severe obesity who have undergone Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG).

METHODS

Food frequency (FF), food habits (FH), physical activity and life style (PA) as well as smoking habits (SH) were analyzed in 50 RYGB (25 M; aged: 24-64) and 50 SG patients (25 M; aged: 22-63) by means of a validated questionnaire, before (T0) and 6 months (T1) post bariatric surgery. A score for each section (FF, FH, PA, SH) was calculated.

RESULTS

ANOVA analysis (age/sex adjusted): FF and FH scores improved at T1 (RYGB and SG: p < 0.001); PA score improved but not significantly; SH score did not change at T1 neither in RYGB nor in SG. Mixed models: FF and PA scores did not correlate with age, gender, weight, BMI, neither in RYGB nor in SG; FH score was negatively correlated both with weight (RYGB: p = 0.002) and BMI (SG: p = 0.003); SH score was positively correlated with age, in SG (p = 0.002); the correlation was stronger in females than in males (p = 0.004).

CONCLUSIONS

Although dietary habits improved, patients did not change their physical activity level or their smoking habits. Patients should receive adequate lifestyle counseling to ensure the maximal benefit from bariatric surgery.

The relationship between smoking and knee osteoarthritis in the Osteoarthritis Initiative

OBJECTIVE

To estimate the extent that smoking history is associated with symptoms and disease progression among individuals with radiographically confirmed knee Osteoarthritis (OA).

METHOD

Both cross-sectional (baseline) and longitudinal studies employed data from the Osteoarthritis Initiative (OAI) (n = 2250 participants). Smoking history was assessed at baseline with 44% current or former smokers. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) was used to measure knee pain, stiffness, and physical function. Disease progression was measured using joint space width (JSW). We used adjusted multivariable linear models to examine the relationship between smoking status and exposure in pack years (PY) with symptoms and JSW at baseline. Changes in symptoms and JSW over time were further assessed.

RESULTS

In cross-sectional analyses, compared to never-smokers high PY (≥15 PY) was associated with slightly greater pain (beta 0.36, 95% CI: 0.01-0.71) and stiffness (beta 0.20, 95% CI: 0.03-0.37); and low PY (<15 PY) was associated with better JSW (beta 0.15, 95% CI: 0.02-0.28). Current smoking was associated with greater pain (beta 0.59, 95% CI: 0.04-1.15) compared to never-smokers. These associations were not confirmed in the longitudinal study. Longitudinally, no associations were found between high or low PY or baseline smoking status with changes in symptoms (at 72 months) or JSW (at 48 months).

CONCLUSION

Cross-sectional findings are likely due residual confounding. The more robust longitudinal analysis found no associations between smoking status and symptoms or JSW. Long-term smoking provides no benefits to knee OA patients while exposing them to other well-documented serious health risks.

Metabolic Syndrome and Chronic Laryngitis: The Korean National Health and Nutrition Examination Survey 2008 to 2010

Metabolic syndrome (MetS) is associated with a higher risk of morbidity and/or mortality for various chronic diseases. The aim of this study was to investigate the relationship of chronic laryngitis (CL) with MetS and its components in a representative Korean population.Data from the Korean National Health and Nutrition Examination Survey (2008-2010) were analyzed. A total of 10,360 adults who had undergone otolaryngological examination were evaluated.The prevalence of CL in the study population was 3.1%. The prevalence of MetS was significantly higher in patients with CL than in those without CL for both sexes (men: 34.7 ± 4.0% versus 25.9 ± 0.8%, P = 0.0235; women: 40.6 ± 5.3% versus 23.7 ± 0.7%, P = 0.0003). Elevated fasting glucose, triglycerides, and blood pressure, however, were only significantly associated with CL in women. After controlling for confounders, CL was only significantly associated with MetS in women (odds ratio: 2.159; 95% confidence interval: 1.2974, 3.594). Furthermore, the association between CL and MetS was most robust in women who were classified as obese.In Korea, MetS and its components are significantly associated with CL in women.

Metabolic syndrome among Jaffna Tamil community, Sri Lanka

AIM

The prevalence and associated risk factors of metabolic syndrome (MS) among adults over 18 years old in Jaffna district.

MATERIALS AND METHODS

It was community-based cross-sectional descriptive study. Multistage stratified cluster sampling technique was employed. An interviewer administered questionnaire was used to obtain the relevant information. Waist circumference (WC) and blood pressure (BP) measurements were recorded. Fasting plasma glucose (FPG), high-density lipoprotein (HDL), and triacylglycerols were analyzed by the enzymatic colorimetric assay using semi-automated analyzer (Teco Diagnostics TC-3300). International Diabetic Federation guideline for Asians was used to identify MS.

RESULTS

Sample response rate was 95.3% and of them, 43.8% (n = 224) was male. The prevalence of central obesity (WC for male ≥90 cm, female ≥80 cm) was 23.9%. Raised FPG (≥100 mg/dL, or previously diagnosed diabetes mellitus), hypertriacylglycerolemia (≥150 mg/dl), low level of HDL cholesterol (<40 mg/dL in males, <50 mg/dL in females), and raised BP (systolic BP ≥130 or diastolic BP ≥85 mmHg or previously diagnosed hypertension) were found in 23.9%, 25%, 79.3%, and 36.6% of the participants. The prevalence of MS was 15.8% (95% confidence interval [CI]: 12.8-19.3) and it was 17.4% in males and 14.6% in females. Participants living in the urban area had a higher prevalence of MS when compared with participants in a rural area (P = 0.015). Older age (P < 0.001) was a risk factor for development of MS. Smoking (P = 0.005) was a risk factor for the development of MS. Participants having sedentary, moderately active, and highly active lifestyle had the prevalence of MS 20.6% (95% CI: 13.2-29.7), 14.7% (95% CI: 10.6-19.5), and 14.7% (95% CI: 9.3-21.6), respectively (P = 0.247).

CONCLUSION

Older age, urban living, and smoking carry a higher risk for development of MS among Jaffna Tamil community.

Predicting Metabolic Syndrome Using the Random Forest Method

Aims. This study proposes a computational method for determining the prevalence of metabolic syndrome (MS) and to predict its occurrence using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. The Random Forest (RF) method is also applied to identify significant health parameters. Materials and Methods. We used data from 5,646 adults aged between 18–78 years residing in Bangkok who had received an annual health check-up in 2008. MS was identified using the NCEP ATP III criteria. The RF method was applied to predict the occurrence of MS and to identify important health parameters surrounding this disorder. Results. The overall prevalence of MS was 23.70% (34.32% for males and 17.74% for females). RF accuracy for predicting MS in an adult Thai population was 98.11%. Further, based on RF, triglyceride levels were the most important health parameter associated with MS. Conclusion. RF was shown to predict MS in an adult Thai population with an accuracy >98% and triglyceride levels were identified as the most informative variable associated with MS. Therefore, using RF to predict MS may be potentially beneficial in identifying MS status for preventing the development of diabetes mellitus and cardiovascular diseases.

Prevalence and factors associated with metabolic syndrome among Tamils aged over 18 years in Jaffna district, Sri Lanka

BACKGROUND

The aim was to determine the prevalence and factors associated with Metabolic Syndrome (MS) among adults aged over 18 years in Jaffna district, Sri Lanka.

METHODS

This study was carried out as a community based cross sectional descriptive study in Jaffna district, Sri Lanka. Multistage stratified cluster sampling technique was employed. Total sample size was 544. An interviewer administrated questionnaire was used to gather data. Waist circumference (WC) and blood pressure (BP) measurements were recorded in standard method. Overnight fasting blood samples were obtained from all subjects. Fasting plasma glucose (FPG), high density lipoprotein (HDL), and triacylglycerols were analyzed by the enzymatic colorimetric assay (Semi Automated analyser Teco Diagnostics TC 3300). Modified National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATP III) criterion was used to define the MS.

RESULTS

Sample response rate was 95.3 %. Of them, 43.8 % (n = 224) was male. Prevalence of central obesity (WC for male ≥102 cm, female ≥88 cm) was 16.2 %. Prevalence of raised FPG (≥100 mg/dL), hypertriacylglycerolaemia (≥150 mg/dl), low level of HDL cholesterol (<40 mg/dL in males, <50 mg/dL in females) and raised BP (systolic BP ≥130 or diastolic BP ≥85 mmHg) were 23.9, 25, 79.3 and 36.6 % respectively. Prevalence of MS was 24.1 % (n = 123, 95 % CI: 20.4-28) and it was 26.8 and 21.9 % among males and females respectively. Participants living in urban area had higher prevalence of MS when compared with participants living in rural area (P = 0.015). Older age (P < 0.001) and smoking (P = 0.005) were risk factor for development of MS. Prevalence of MS among the participants with sedentary and active lifestyle was 29.9 and 23.7 % respectively.

CONCLUSION

One out of four had MS. Old age, urban living and smoking carried higher risk for developing MS in Jaffna community.

Factors influencing insulin resistance in relation to atherogenicity in mood disorders, the metabolic syndrome and tobacco use disorder

OBJECTIVE

This study examines the effects of malondialdehyde (MDA) and uric acid on insulin resistance and atherogenicity in subjects with and without mood disorders, the metabolic syndrome (MetS) and tobacco use disorder (TUD).

METHODS

We included 314 subjects with depression and bipolar depression, with and without the MetS and TUD and computed insulin resistance using the updated homeostasis model assessment (HOMA2IR) and atherogenicity using the atherogenic index of plasma (AIP), that is log10 (triglycerides/high density lipoprotein (HDL) cholesterol.

RESULTS

HOMA2IR is correlated with body mass index (BMI) and uric acid levels, but not with mood disorders and TUD, while the AIP is positively associated with BMI, mood disorders, TUD, uric acid, MDA and male sex. Uric acid is positively associated with insulin and triglycerides and negatively with HDL cholesterol. MDA is positively associated with triglyceride levels. Comorbid mood disorders and TUD further increase AIP but not insulin resistance. Glucose is positively associated with increasing age, male gender and BMI.

DISCUSSION

The results show that mood disorders, TUD and BMI together with elevated levels of uric acid and MDA independently contribute to increased atherogenic potential, while BMI and uric acid are risk factors for insulin resistance. The findings show that mood disorders and TUD are closely related to an increased atherogenic potential but not to insulin resistance or the MetS. Increased uric acid is a highly significant risk factor for insulin resistance and increased atherogenic potential. MDA, a marker of lipid peroxidation, further contributes to different aspects of the atherogenic potential. Mood disorders and TUD increase triglyceride levels, lower HDL cholesterol and are strongly associated with the atherogenic, but not insulin resistance, component of the MetS.

Translational Research on Nicotine Dependence

Nicotine dependence is a chronic, relapsing disorder with complex biological mechanisms underlying the motivational basis for this behavior. Although more than 70 % of current smokers express a desire to quit, most relapse within one year, underscoring the need for novel treatments. A key focus of translational research models addressing nicotine dependence has been on cross-validation of human and animal models in order to improve the predictive value of medication screening paradigms. In this chapter, we review several lines of research highlighting the utility of cross-validation models in elucidating the biological underpinnings of nicotine reward and reinforcement, identifying factors which may influence individual response to treatment, and facilitating rapid translation of findings to practice.

Chronic obstructive pulmonary disease and the metabolic syndrome: Consequences of a dual threat

The metabolic syndrome is found to be more frequent in chronic obstructive pulmonary disease (COPD). The presence of inflammatory markers in circulation, sputum, and broncho-alveolar fluid suggest systemic inflammation is one of the potential mechanisms responsible for both COPD and metabolic syndrome. Physical inactivity, skeletal muscle dysfunction, hypogonadism, and steroid use are also important causes of the metabolic syndrome in COPD. Obesity and insulin resistance is found to be more common in mild to moderate stages (I and II) of COPD. Patients with COPD and the metabolic syndrome have increase risk of morbidity and mortality due to cardiovascular disease. This review describes in details the various components of metabolic syndrome and its impact on long outcomes in COPD patients.

Associations of cigarette smoking and alcohol consumption with metabolic syndrome in a male Chinese population: a cross-sectional study

Background

Whether cigarette smoking and alcohol consumption are associated with the risk of metabolic syndrome (MetS) remains controversial. This study investigated the associations of cigarette smoking and alcohol consumption with MetS in a male population in China.

Methods

We conducted a cross-sectional study. A questionnaire was used to collect data on cigarette smoking, alcohol consumption, MetS status, and other related information from 8169 men aged 19–97 years. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between smoking and alcohol consumption and the risk of MetS.

Results

The prevalence of MetS was 15.2% in the study population. Proportions of current smokers and drinkers were 48.2% and 46.5%, respectively. Adjusted OR of MetS was 1.34 (95% CI, 1.01–1.79) among smokers who smoked ≥40 cigarettes/day compared with nonsmokers and 1.22 (95% CI 1.03–1.46) for those who consumed 0.1–99 grams of alcohol/day compared with nondrinkers. Adjusted OR was 2.32 (95% CI 1.45–3.73) among ex-drinkers who never smoked, 1.98 (95% CI 1.35–2.91) among ex-drinkers who were current smokers, and 1.34 (95% CI 1.08–1.68) among current drinkers who never smoked compared with those who neither smoked nor drank. There was a significant interaction between smoking and drinking alcohol on MetS (P for interaction is 0.001).

Conclusions

Our study indicated that smoking and drinking is associated with higher prevalence of MetS. Interactions between smoking and drinking on the risk of MetS in men in China may also exist. Our findings need to be confirmed in future case-control or cohort studies.

Association between presence of the metabolic syndrome and its components with carotid intima-media thickness and carotid and femoral plaque area: a population study

BACKGROUND

We aimed to explore the association between presence and number of components of the Metabolic Syndrome (MetS) and subclinical atherosclerosis outcomes (common carotid intima media thickness, plaque presence and sum of plaque area) in both the carotid and femoral bifurcations.

METHODS

Cross-sectional analysis of 771 volunteers from the ongoing epidemiological Cyprus Study (46% male; mean age = 60.1 ± 9.8). (a) Carotid intima-media thickness (IMTcc), (b) sum of plaque area in the carotid bifurcations (sum of the largest plaques in each carotid bifurcation-SPAcar), (c) sum of plaque area in the femoral bifurcations (sum of the largest plaques in each femoral bifurcation-SPAfem) and (d) sum of plaque area in both carotid and femoral bifurcations (sum of the areas of the largest plaques present in each of the four bifurcations-SPA) were measured at baseline using ultrasound. Presence and number of components of the MetS was ascertained using the National Cholesterol Education Program ATPIII definition and their association tested using multivariable regression models.

RESULTS

MetS was present in 259 (33.6%) individuals and was associated with a 0.02 mm increase in IMTcc (95% CI: 0.00 to 0.04, p = 0.047) after adjustment for age, sex, family history of CVD, alcohol consumption (BU/week) and smoking (pack-years). Each additional component of the MetS was associated with a 16% higher SPA (95% CI: 6.8% to 25.2%, pfor trend = 0.001), a 10% higher SPAcar (95% CI: 5% to 24%, pfor trend = 0.003) and a 14% higher SPAfem in the adjusted model.

CONCLUSIONS

We confirm an association between the MetS and IMTcc as well as report for the first time an association between the MetS and its components and femoral plaque area, in a general population over 40 years of age. Having any risk factors for the MetS increases the risk for subclinical atherosclerosis, with the risk increasing with each additional component. Using the dichotomous definition of the MetS may be overlooking the risk for subclinical atherosclerosis -and by inference future cardiovascular events- associated with having less than 3 risk factors.